Last updated on April 15th, 2020 at 04:39 pm

For all cardiac arrests the following procedure MUST be followed to ensure patient and staff safety:

No more than 5 team members to enter a room or bay whilst a cardiac arrest is in progress

·      Cardiac Arrest Trolley MUST stay outside the room

·      Defibrillator and pads to be passed into the room first, person wearing surgical mask, plastic apron, gloves and eye protection to deliver 3 stacked shocks, if shockable rhythm,  then leave the room – no ventilations or compressions follow the new ALS algorithm

·      One person to stay with the trolley outside the room as “Gatekeeper” wearing a surgical mask, plastic apron, gloves and eye protection. They must ensure only 5 team members maximum enter the room

·      The Gatekeeper must ensure staff don on long sleeved surgical gown, gloves, FFP3 mask and visor or goggles before to entering the room and starting resuscitation.  Visors should be used when available, if none available and the PPE mask has a valve, then a surgical mask must be put on over the FFP3 valve mask and googles worn. Full PPE x 5 stored in bottom of the arrest trolley and in ward clean utility room

·      The Gatekeeper is responsible for passing items from the trolley into the room as required by finger-tip

·      Advanced airway management, intubation and use of igels only to be performed by anaesthetic staff only ensuring that a HME filter is attached to the circuit/BVM (see guidance below)

·      Disposable equipment must not leave the room until bagged for disposal

·      Blood samples are to be placed in a blue bag held by an external member (not the gatekeeper) they will complete a requisition form if required. In the case of ABGs this person (someone who can do ABG testing) should take the ABG sample to the nearest ABG machine available to carry out the testing wearing gloves

·      Non-disposable equipment – defibrillator, leads etc. must be cleaned as per IPC instructions immediately to ensure equipment is available ASAP Please direct any questions relating to the above procedure to paul.craven@sthk.nhs.uk

ALS Algorithm Flowchart

Adult Advanced Life Support for COVID-19 PatientsDownload

HME Filter Guidance

As per current guidance, a HME Filter MUST be attached to the BVM device prior to performing ventilation.  Please see below pictures:

  • A HME Filter is commonly used in Anaesthetics, it is a small device which sits between the circuit/bag valve and the mask. 
  • The purpose of the HME filter is for the protection of the patient, hospital personnel and the equipment from potential microbial contamination, both bacterial and viral – including COVID-19. 
  • The filters are for single patient use and must be disposed of after use as per the ICP and can be restocked from Cardio-Respiratory.